Warts

Warts are growths on the skin or mucous membranes that may protrude and be rough or they may be very smooth and flat.  Warts are caused by infection with the human papilloma virus (HPV).  They can be spread from person to person or be transmitted via objects, such as towels or shoes.  They normally disappear after a few months, but they can persist and spread for years.  Even though warts are contagious, infection is more dependent on a person’s lack of immunity than virulence of the virus.

There are approximately 130 strains of human papilloma viruses.  Some strains are responsible for deep warts on the bottom (or “plantar” surface) of the feet ( “plantar warts”) or  palms. Other strains are responsible for flat warts, and still other strains are responsible for genital warts. Still other HPV strains are associated with cancer of the cervix, mouth, larynx, trachea and lungs.

There is not one good treatment for warts which is why there are so many different treatments. One theory in the treatment of warts is that we are really stimulating one’s own immune system to eradicate the wart virus.  In instances where the immune system is severely compromised as in HIV/AIDS, it is very difficult to eradicate the virus infection.

Liquid nitrogen cryotherapy; lasers; various chemicals such as cantharadin, salicylic acid, dinitrochlorobenzene (DNCB) or squaric acid dibutyl ester immunotherapy, intralesional bleomycin, 5-fluorouracil, and  Imiquimod; and electrodesiccation are all used with success. Hypnotherapy is also useful in some people.  The goal in all treatments is removal of the wart(s) without a residual mark on the skin.

This discussion would be incomplete without advocating that all young adolescents be immunized with Gardasil which protects against several strains of HPV that are most responsible for cervical dysplasia and carcinoma of the cervix.  Initially it was recommended solely for young women, but immunizing young men will confer a more complete protection from this devastating condition.